ESTRO 35 Abstract Book

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ESTRO 35 2016 S665
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progression was 5.0 months (95%CI: 1.8-8.1). In 22 patients
with pain, a significant reduction of this symptom was
recorded in terms of VAS (mean baseline VAS vs mean VAS at
follow-up: 4.6 versus 3.1, p<0.001).
Conclusion: Short-course accelerated H&N radiotherapy (20
Gy in twice daily fractions for 2 consecutive days) is
tolerated and effective in terms of symptom relief. A phase
III comparison against a standard palliative regimen (30 Gy in
10 fractions) has been planned in this patient population.
EP-1430
Phase II study of short-course accelerated palliative
radiation therapy for advanced thoracic tumors
J. Capuccini
1Department of Experimental- Diagnostic and Specialty
Medicine - DIMES- University of Bologna, Radiation Oncology
Center, Bologna, Italy
1, L. Caravatta2, F. Deodato3, G. Torre3, A.
Farioli4 , M. Buwenge1, G. Macchia3, S. Manfrida5, S. Cilla6, S.
Mignogna7, W. Tigneh8, A.F.M.K. Uddin9, T. Salah10, D.
Dawotola11, A.A. Woldemariam8, P.A. Banu12 , M. Moroni13, A.
Veraldi1, A. Arcelli1, F. Bertini1, S. Cammelli1, V. Valentini5,
A.G. Morganti1
2Centro di Radioterapia e Medicina Nucleare- P.O. Businco,
Cagliari, Italy
3Fondazione di Ricerca e Cura “Giovanni Paolo II”- Università
Cattolica del Sacro Cuore, Radiotherapy Unit, Campobasso,
Italy
4S. Orsola-Malpighi Hospital- University of Bologna-,
Department of Medical and Surgical Sciences - DIMEC,
Bologna, Italy
5Policlinico Universitario “A. Gemelli”- Università Cattolica
del Sacro Cuore, Department of Radiotherapy, Roma, Italy
6Fondazione di Ricerca e Cura “Giovanni Paolo II”- Università
Cattolica del Sacro Cuore, Medical Physics Unit, Campobasso,
Italy
7Fondazione di Ricerca e Cura “Giovanni Paolo II”- Università
Cattolica del Sacro Cuore, General Oncology Unit,
Campobasso, Italy
8Black Lion Hospital, Department of Radiotherapy, Addis
Ababa, Ethiopia
9United Hospital Limited, Radiation Oncology Department,
Dhaka, Bangladesh
10Assiut University, Faculty of Medicine, Assiut, Egypt
11Radiotherapy and Oncology Centre- Abuth- Zaria,
Department of Radiotherapy, Abuth- Zaria, Nigeria
12Delta Medical Center, Radiation Oncology Department,
Dhaka, Bangladesh
13Fondazione Seragnoli, Hospice Bentivoglio, Bologna, Italy
Purpose or Objective: To assess the effectiveness of a SHort-
course Accelerated RadiatiON therapy (SHARON) in the
palliative treatment of patients with primary or secondary
thoracic neoplasms, symptomatic, and not susceptible of
surgery or radical radiotherapy.
Material and Methods: A phase II clinical trial was planned
based on optimal two-stage Simon’s design. Eligibility criteria
included patients with an Eastern Cooperative Oncology
Group (ECOG) performance status of ≤3 and an expected
survival > 3 months. Twenty-five patients were treated with
radiotherapy (total dose: 20 Gy, 5 Gy per fraction) in 2 days
with twice daily fractionation. The primary endpoint was to
evaluate symptoms response rate.
Results: Characteristics of the 25 enrolled patients were:
male/female: 18/7; median age: 73 years (range: 46-93).
ECOG performance status was <3 in 24 patients (96%). Two
G1 skin (8%), 7 G1 haematological (28%) and 4 G1 pulmonary
(16%) toxicities were recorded. No patient experienced G≥2
acute toxicities. With a median follow-up time of 6 months
(range, 1 to 16 months), of the 25 symptomatic patients, 24
showed an improvement or resolution of baseline symptoms
(overall palliative response rate: 96%). Three months overall
survival was 87.5% (median survival time: 6 months; 95% CI
5.3-6.6 mo). Median survival without symptoms progression
was 3 months (95% CI:2.2-3.7mo). In 24 patients with pain, a
significant reduction of this symptom was recorded in terms
of VAS (5.0 vs 2.9, p=0.02).
Conclusion: Short-course accelerated thorax radiotherapy
(20 Gy in twice daily fractions, 2 consecutive days) is
tolerated and effective in terms of symptom relief. A phase
III comparison against a standard palliative regimen (30 Gy in
10 fractions) has been planned in this patient population.
EP-1431
SBRT for patients with spine metastases using LINAC
Y. Mironova
1Regional Oncology Clinic, Radiotherapy, Ekaterinburg,
Russian Federation
1, D. Bentsion1, S. Bayankin1
Purpose or Objective: Modern technologies of radiotherapy
(SBRT,SABR) are utilized to treat patients with solitary spine
metastases. Clinical studies have shown the efficacy of
image-guided SBRT for pain control, local tumor control, as
well as improvement of the life`s quality for these patients.
In our clinic we have been using this method since 2013 for
primary and re-irradiation treatment.
Material and Methods: We have treated 32 pts (20 primary,
12 reirradiation), 44 lesions. Eligible criteria were ECOG 1-2,
spine metastases confirmed by MRI, the number of lesions
were less than 3, adequate control of the primary tumor.
Mean age 55.8 y.o. (47-72); gender distribution: 12 men and
20 women. Option of the radiation dose and limit critical
organs were installed according to the recommendations
Elekta Spine Radiosurgery Research Consortium (ESRRC) and
RTOG 0631. The prescribed dose was 12-24 Gy in 1-3 fr. For
re-irradiation we have used the recommendations of Nieder
et al.(2006): BED of each course - 98Gy, total BED -135.5Gy,
the interval between two treatments was more than 6
months. In these cases the prescribed dose was 20Gy in 5 fr.
The procedure was performed by VMAT on a linear
accelerator Elekta Synergy S, equipped with a 4-mm MLC,
image-guided system (Elekta XVI), 6D robotic positioning
system table (HexaPod). Overall duration of procedures was
20-45 min. The follow-up was every 3 months from treatment
time. It was assessed the pain intensity on a 10-point VAS,
analgesics, performed MRI control.
Results: Toxicity of SBRT was assessed by using CTC AE
(v.4.0). Nausea gr.1 was observed in 3 (9.4%) pts, vomiting
gr.1 - 1 (3.1%) pt. Toxicity gr.3-4 has not been observed.
There were no cases of therapy interruption due to poor
tolerability. Hematological toxicity during follow-up period
was not revealed. In average of the period of 3 weeks all
patients showed relief of pain syndrome with moderate (4-6
points) to the minimum (1-3 points). The overall response to
treatment (decrease of pain syndrome, local tumor control
by MRI) was 90.6%, including a complete pain relief - 8 (25%)
pts, stabilization - 21 (65.6%), lack of response to the
treatment- 3 (9,4%). One patient had a pathological
compression fracture of the vertebra at 4 months after
irradiation, which required surgical intervention (installation
of the fixing system). According to one patient`s MRI after 3
month of treatment, we have revealed soft tissue component
of tumor (MRI).
Conclusion: SBRT was well tolerated. We did not observe any
clinically significant toxicity. Reduction of the overall
treatment time was comfortable for patients and increase
capacity of LINAC. Further research is necessary to evaluate
the efficacy and toxicity of the treatment and the
development of criteria for the selection of patients.
EP-1432
Predicting pain response after conventional radiotherapy
in 1018 patients with bone metastases
J.M. Van der Velden
1University Medical Center Utrecht, Radiation Oncology,
Utrecht, The Netherlands
1, H.M. Verkooijen 1, A.L. Versteeg2, A.S.
Gerlich3, J.J. Verlaan2, L. Zhang3, M. Tsao3, C. Danjoux3, E.
Barnes 3, M. Van Vulpen1, E. Chow3